Now my FIL only eats sweet food. He refused to take on regular food. But if the caregiver feeds him by spoon (all pureed) he would eat it nicely.

Is this a form of refusing food by not taking it? It is still OK that he can be fed. Is it because he does not think regular food is food and is not tasty?
There is a scientific article that indicates AD patient in the end likes sweets more than salt because of the way the brain works.

He is not taking Ensure yet because the NH believes in pureed food first. But now it takes longer to feed him.
Sometimes they may feed him later after everyone is served. Or they wait to see if he can do it himself. But he has not done so since April.

Yes, there is a preference for sweet foods in many dementia patients. Sweet foods in nature are high calorie and filled with nutrients we need to survive.

Is he refusing to eat other pureed foods that are fed to him or just not eating regular foods other than deserts by himself? Mom, if left to her own wishes, would only eat the dessert. But if fed she will eat what is put in her mouth.

The inability to get food to the mouth is one part of this disease and the inability to swallow is another. If they can't get food to their mouth by themselves but they will eat and swallow once it is fed to them then it is OK. They just need to be fed and it doesn't matter how long that takes. It is when they lose the ability to swallow the food and choke that it become a problem.

Ensure is a supplement not a substitute for food (though that is what is used in many feeding tubes). If your FIL is losing weight then his intake could be supplemented with the Ensure. He can have both at the same time. Many of the residents in Mom's facility are still on regular food (mechanical soft) but losing weight so they also receive Ensure.

He eats everything for now, being fed or not. We really have to see what is going on tomorrow. Now he eats in the west wing so things are quieter there.
Today he was still eating at 1:30pm when we called him. They do have lunch from 12pm to 1pm.

I guess as long as he can eat everything, it is fine. I think it is his hands that he has trouble with. Not the food although he prefers the sweet. You would be amazed: every time he sees the sweet stuff after he tries, his eyes light up like kids! It is like he found the treasure... He would make trouble to pick up the sweet stuff, but not the regular food like mashed potato (the color is white anyway...) He knows apple sauce is good. Puff too. Watermelon is OK.

So I guess as long as he eats, it is good!

On the phone, he no longer talks well now. Just hello or bye. Not sure he knows how to use the phone - the voice is too soft now. (Not talking to the phone.)
He is declining now and within a year, he will be very different.
The director did say it is some change that he only picks up sweet stuff.

Sure they still have preferences and sweet is usually something they prefer. As long as he is eating and is not having trouble swallowing, that is a good thing.

More than likely it is a problem with the brain being unable to perform the task of feeding himself. Some forget how to use the utensils. Mom just banks the fork against the knife. But if I take them away she will pick up pieces and eat with her fingers. Other days she will use her fork. Today she just sat and looked at her food until I fed her. But she eats and that's good.

It has been three years since Mom could carry on any conversation on the phone. It's just a box with a noise in it. She does more looking at the phone than listening or talking in it. It has been over two years since we have attempted phone conversation at all. A voice coming out of a plastic box is not something they understand. Not to mention the auditory processing deficiencies. Much of what they understand is from non verbal cues rather than the spoken language and you take that away with phone conversation.

Definitely, my FIL has trouble swallowing. That is why he pocked his food in his mouth and takes longer to swallow the food. Now he takes an hour to be fed.
The NH said he is OK in the East wing so there is no fixed way to get him eat. As long as he can eat.

We observed him and fed him dinner in the west wing Sunday night. There are these patients who all need to be fed. No kidding, All residents there in the west wing have to be fed. The girls have to take turns to feed them. One guy was fed the last because he was playing with the chair/floor and whatever. When the girl fed him, the food was cold. It is sad. It is not one on one so the feeding is a bit here and there...
It is like a smaller dining area with the TV on. (The TV noise was quieter when they eat.) There are 6 tables (each for 4) around the TV area, and 2 more tables next to the nurse station. All 32 patients but not all of them there. There are 3 other families there trying to feed their elders.

Yea! The same guy that "hated" me came over again! Well the door in the west wing was not closed until 6:30pm. The guy came over after dinner with a walker to see what is going on. Yes he is really nosy. This time, he forgot about us. He did ask one caregiver how come you are here? He looked around and he found this lady who used to be in the East wing. He touched her cheek to make fun of her. At this point, the caregivers made him leave and closed the door of the wing behind him!! There was another guy who came over for drink as well (just excuse.)

My FIL still wanted to finish his regular food. He still loves the dessert but he demanded to finish his regular food. He did eat the dessert by himself sometimes, but he was choked by that since he had larger bit for desserts. He even yelled at me when I trie to feed him dessert while mashed potato was not finished yet... Now he no longer talks. He yells out "Ah" in anger. He did that when my husband tried to move his legs to the paddles and etc. He does not yell at others for the leg issue. I guess he thought when he saw us, he could just be a child and do anything he likes. He is mean to my husband at times. Yet he smiled at him Monday morning when we sat together for music. He does not like music that much anymore unless the music piece is famous.

He now does not like juice or water unless he has a mouthful of food.

Yes he does have swallowing problem and he takes longer to swallow. He knows he does not want the solid cookie or juice anymore. He just does not want to be choked.

Not sure what was wrong, but my FIL was a bit upset himself when we moved him out of the west wing after dinner to go back to the east side. Either he was upset by the sick patients in the west wing (most of them are like dolls that don't move a lot or move too much) or he was upset by being in the west side.
He was very alert Monday and then he forgot what was wrong. He does not walk or talk anymore and does not mind it. We can still tell that he still tries to be "normal" so he still does not fit the west wing for sicker people.

Maybe in 6 or 9 months, he will be more different. He has had swallowing problem since April given pureed food.

".....my FIL has trouble swallowing..." thus the need for the puree but as long as he is successfully eating it is ok. It truly doesn't matter how long it takes, just that he does eat. Having more than one to feed is typical. It is not unusual for me to go in and feed Mom and her table mate. They do have to help a few residents and then a few more residents. Food is kept in a hot box so it is delayed but not cold. It is just a part of the later stages of this disease. As for not liking juice or water... have they tried thickened liquids? Water and juice can be a choking hazard with swallowing issues.

Dementia patients wander from place to place with no particular purpose in mind. We can't attached logical rational meaning to irrational dementia behavior. The guy who came over for a drink probably actually wanted a drink. Their cognitive level doesn't lead to deception. They are in the moment without the ability to pre think their actions. The guy from the past didn't remember you at all. As before he was just curious. As for knowing he will choke with certain items... I doubt he makes that cognitive connection. ....."He did eat the dessert by himself sometimes, but he was choked by that since he had larger bit for desserts.".... this is more common and why you have to monitor their eating. The fact that he is pocketing food means he is putting things in his mouth that he can not manage to swallow.

...."Not sure what was wrong, but my FIL was a bit upset himself when we moved him out of the west wing after dinner to go back to the east side. Either he was upset by the sick patients in the west wing (most of them are like dolls that don't move a lot or move too much) or he was upset by being in the west side."..... I doubt he was cognitively aware of where he was or who was there. He was being moved and that is enough. You commented that he had just yelled AH at your husband and if your husband was still there then that is probably FIL's concern in the moment. Or it could have been something as simple as him being uncomfortable in the chair. Those in later stages of dementia are focused on self and not much else.

As for the time line of deterioration.... nobody knows. It could be sooner or later. You just take one step at a time being aware of what is going on.

Deb, you totally underestimate these elders.
Some patients are only in mid-stage to moderate stage.

For sure my FIL knows who he is seeing. He knows a patient when she wanders blindly. He was a MD so he can tell. He mocked at the patients who sleep without knowing that he is sleeping all day himself.

These elders know that there is another wing. The guy didn't just come for drink. He came for a fun time after his dinner. He was looking for things to do. The same guy Jack who hated me came over to see his old friends. He knows this is another wing.

Don't write them out too early. I admit the patients in the west wing would know nothing about the surroundings.

My FIL does. That is why it is hard to move him to even the west wing.